US9089321B2

Movatterモバイル変換

Info

Publication number: US9089321B2
Application number: US13/652,003
Authority: US
Inventors: Terry H. SNYDER; Daniel D. Fritzinger
Original assignee: Biomet Sports Medicine LLC
Current assignee: Biomet Manufacturing LLC
Priority date: 2012-10-15
Filing date: 2012-10-15
Publication date: 2015-07-28
Also published as: US20160000426A1; US9877716B2; US20140107673A1

Abstract

A suture passer assembly is used for manipulating a suture with a selectively moveable wire member. The suture passer assembly includes at least one grasping member and a single-body hollow tube. The tube defines a first end, a second end, a tube wall, and a tube passage extending from the first end to the second end. The wire member is moveably received within the tube passage. The tube wall includes at least one aperture that is disposed between the first end and the second end. A first portion of the grasping member extends through the tube wall and into the tube passage via the aperture. A second portion of the grasping member remains outside the hollow tube. The first portion is operable to grasp the wire member and selectively move the wire member relative to the hollow tube due to manipulation of the second portion of the grasping member.

Description

FIELD

The present disclosure relates to a wheeled suture passer and, more particularly, to a wheeled suture passer for securely advancing a wire for use as a suture retrieve or other appropriate use.

BACKGROUND

This section provides background information related to the present disclosure which is not necessarily prior art.

Damaged anatomical tissue can be repaired using sutures. A typical suture can be threaded through two separate areas of tissue, and the suture can be tied to thereby attach the areas of tissue. As such, the areas of tissue can be held together by the suture and, over time, the areas of tissue can heal together to restore function of the anatomy. These procedures can be used for various surgical procedures, such as repair of a torn rotator cuff, etc.

Threading the suture through tissue and then tying a knot in the suture can be difficult, especially when the procedure is performed arthroscopically. This is because the surgeon's view of the area can be limited, because there can be relatively little open space within the anatomy to work, etc. Thus, various suture passers have been proposed for facilitating these procedures.

SUMMARY

This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.

A suture passer assembly is disclosed that is used for manipulating a suture with a selectively moveable wire member. The suture passer assembly includes at least one grasping member and a single-body hollow tube. The tube defines a first end, a second end, a tube wall, and a tube passage extending from the first end to the second end. The wire member is moveably received within the tube passage. The tube wall includes at least one aperture that is disposed between the first end and the second end. A first portion of the grasping member extends through the tube wall and into the tube passage via the aperture. A second portion of the grasping member remains outside the hollow tube. The first portion is operable to grasp the wire member and selectively move the wire member relative to the hollow tube due to manipulation of the second portion of the grasping member.

Moreover, a method of selectively moving a portion of a suture from a first anatomical location to a second anatomical location is disclosed. The method includes inserting a hollow tube of a suture passer assembly into a patient toward the first anatomical location and toward the portion of the suture. The hollow tube is a single body defining a first end, a second end, a tube wall, and a tube passage extending from the first end to the second end. A wire member with a gripping end is moveably received within the tube passage. The tube wall includes at least one aperture that is disposed between the first end and the second end. The suture passer assembly also includes at least one grasping member with a first portion extending through the tube wall and into the tube passage via the at least one aperture. A second portion of the at least one grasping member remains outside the hollow tube. Additionally, the method includes manipulating the second portion such that the first portion pushes the gripping end of the wire member out of the hollow tube from the second end. Furthermore, the method includes manipulating the second portion such that the first portion pulls the gripping end and the portion of the suture toward the hollow tube to secure the portion of the suture to the suture passer assembly. Moreover, the method includes moving the portion of the suture to the second anatomical location using the suture passer assembly.

Still further, a suture passer assembly for manipulating a suture is disclosed. The suture passer assembly includes a wire member. The assembly also includes a handle member with a handle passage defined therethrough and a first wheel and a second wheel that are each rotatably supported on the handle member. Additionally, the assembly includes a single-body hollow tube defining a longitudinal axis, a first end, a second end, a tube wall, and a tube passage extending from the first end to the second end. The hollow tube is received within the handle passage, and the wire member is moveably received within the tube passage. The tube wall includes a first slot and a second slot that are each disposed between the first end and the second end and that are disposed on opposite sides of the longitudinal axis. The first wheel partially extends through the first aperture and into the hollow tube, and the second wheel partially extends through the second aperture and into the hollow tube. The first and second wheels are operable to cooperatively grasp the wire member within the tube passage such that driving rotation of at least one of the first wheel and the second wheel advances the wire member relative to the tube member.

Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.

DRAWINGS

The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.

FIG. 1 is an isometric view of a suture passer illustrated according to various exemplary embodiments of the present disclosure;

FIG. 2 is an exploded view of the suture passer ofFIG. 1;

FIG. 3 is a longitudinal sectional view of a tube of the suture passer ofFIG. 1;

FIG. 4 is a longitudinal sectional view of the suture passer ofFIG. 1;

FIG. 5 is an isometric view of the suture passer ofFIG. 1, wherein a portion of a handle member has been removed; and

FIGS. 6-10 are isometric views of the suture passer ofFIG. 1 shown being used to pass a suture through anatomical tissue.

Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.

DETAILED DESCRIPTION

Example embodiments will now be described more fully with reference to the accompanying drawings.

Referring initially toFIGS. 1 and 2, asuture passer assembly10 is illustrated according to various exemplary embodiments of the present disclosure. As will be discussed, thesuture passer assembly10 can be used for manipulating a suture12 (FIGS. 6-10). More specifically, a wire member14 (FIGS. 7 and 8) can be moveably mounted within thesuture passer assembly10, and thesuture passer assembly10 can be used to selectively move thewire member14 for manipulating the suture12 (e.g., for passing thesuture12 through anatomical tissue) as will be discussed in greater detail below.

As shown inFIGS. 1 and 2, thesuture passer assembly10 can include ahandle member16. Thehandle member16 can include afirst portion18 and asecond portion20 that are joined together in a clam-shell or other type of configuration. Thehandle member16 can be made of a polymeric or other type of material. The first and

second portions

18,20 can cooperate to define ahandle end22 of thehandle member16, which the user (e.g., a surgeon) can comfortably hold in one hand. The first and

second portions

18,20 can also cooperate to define alead end28 of thehandle member16. Thelead end28 can be frustoconical in shape and can be disposed on an opposite end of thehandle member16 from thehandle end22. Moreover, one or both of the first and

second portions

18,20 can also define afirst hub24 and a second hub26 (FIG. 2). The

hubs

24,26 can be cylindrical and can extend perpendicularly between the first and

second portions

18,20, within thehandle member16. Additionally, thehandle member16 can define a handle passage30 (FIG. 4) that extends longitudinally therethrough along an axis X. As shown inFIG. 4, thewire member14 can be moveably received within thehandle passage30.

Thesuture passer assembly10 can also include at least one grasping

member

32a,32bthat are operable to selectively grasp and advance thewire member14 relative to thehandle member16 and other portions of theassembly10. In the embodiments illustrated, there are two

grasping members

32a,32bthat are embodied as afirst wheel34 and asecond wheel35, respectively. However, it will be appreciated that there could be a single grasping

member

32a,32bor any other number of grasping

members

32a,32bwithout departing from the scope of the present disclosure. Moreover, the grasping

members

32a,32bcould be embodied in ways other than thewheels34,35 (e.g., such as levers, sliders, etc.) without departing from the scope of the present disclosure.

The

wheels

34,35 can both be cylindrical and can both include anouter diameter surface36. Also, theouter diameter surface36 can be defined by sets of teeth38 (cogs, radial projections, etc.). Theteeth38 can have a generally triangular profile as shown inFIG. 5, but theteeth38 can have any suitable grippable or engageable shape. Theouter diameter surface36 can also be defined by acompressible member40 of the

respective wheel

34,35. Thecompressible member40 can be made from a compressible, but relatively high friction material, such as rubber, foam, etc. However, themember40 can be substantially incompressible and rigid in some embodiments as well. Also, in the embodiments shown inFIG. 5, thecompressible member40 can be an annular band that is disposed longitudinally between the sets ofteeth38 of the

34,35 can be rotationally supported on the

hubs

24,26, respectively (FIG. 4). As such, the

wheels

34,35 can rotate about respective rotational axes R1, R2 relative to thehandle member16.

As will be discussed, thecompressible member40 can abut and frictionally engage thewire member14. Thus, rotation of the

wheels

34,35 about the axes R1, R2 can advance (i.e., push or pull) thewire member14 within theassembly10.

Also, the

wheels

34,35 can be mounted such that the set ofteeth38 of thefirst wheel34 can meshingly engage the set ofteeth38 of thesecond wheel35. Accordingly, the user can drivingly rotate only one

wheel

34,35 to thereby drivingly rotate the

other wheel

34,35 for added convenience and improved ergonomics.

It will be appreciated that theouter diameter surface36 can include radial projections having shapes, spacing, etc. other than those of the illustratedteeth38 for meshingly engaging the

wheels

34,35. Additionally, in some embodiments, the outer diameter surfaces36 can be smooth such that the

wheels

34,35 do not meshingly engage. Otherwise, in some embodiments, the outer diameter surfaces36 can be smooth and can frictionally engage each other so that the

wheels

34,35 can rotatably drive each other.

Furthermore, theassembly10 can include ahollow tube42. Thehollow tube42 can be a monolithic body (i.e., single body, uni-body construction, etc.). Thetube42 can be constructed from metal or polymer. Thetube42 can also extend along the longitudinal axis X. As shown inFIGS. 2 and 3, thetube42 can define afirst end44, asecond end46, and atube wall48. Thefirst end44 and much of thesecond end46 can be axially straight; however, terminal portions of thesecond end46 can axially curve as shown inFIGS. 1 and 2. Thesecond end46 can also include sharpened edges such that thesecond end46 can be used for cutting anatomical tissue as will be discussed.

Thetube wall48 can define aninner tube surface50 and anouter tube surface52 as shown inFIG. 3. Moreover, atube passage53 can extend longitudinally along the axis X through thetube42. Thetube passage53 can extend continuously along thetube42 between thefirst end44 and thesecond end46. As will be discussed, thewire member14 can be moveably received within thetube passage53.

Thetube42 can be fixedly attached and supported by thehandle member16. More specifically, the first and

second portions

18,20 of thehandle member16 can be attached such that thefirst end44 of thetube42 is enclosed within thehandle passage30 and sandwiched between the first and

second portions

18,20 of thehandle member16. As shown inFIGS. 2 and 4, thetube wall48 can include one or more orientation openings59 (e.g., slots) that receive complementary projections of the first and/or

second portions

18,20 for further securing thetube42 to thehandle member16. Adhesives, fasteners, or other means can additionally be used for securing thetube42 to thehandle member16. With thefirst end44 secured to thehandle member16, thesecond end46 of thetube42 can extend out from and can be exposed from thehandle member16.

As shown inFIGS. 2-5, thetube wall48 can include at least oneaperture54. Theaperture54 can be disposed between the first and second ends44,46 of thetube42. In the embodiments illustrated inFIGS. 3 and 4, thetube wall48 includes twoapertures54 that are embodied as respective

elongate slots

56,58. The

slots

56,58 can extend radially through both theinner tube surface50 and theouter tube surface52. Also, the

slots

56,58 can extend substantially parallel to the axis X and can be disposed symmetrically on opposite sides of the axis X. As shown inFIG. 3, the

slots

56,58 can taper outward from theinner tube surface50 to theouter tube surface52. However, it will be appreciated that thetube42 can include any number ofapertures54, and the aperture(s)54 can have any suitable shape and any suitable position on thetube wall48.

As shown inFIG. 4, afirst portion60 of each

wheel

34,35 can be received within the

slots

56,58, respectively. Specifically, thefirst portion60 is defined at an inner radial segment of thecompressible member40 as the

wheels

34,35 rotate. Thesefirst portions60 extend through thetube wall48 and radially into thetube passage53 via the

respective slot

56,58. The

slots

56,58 can be shaped and sized such that thefirst portion60 substantially fills the entire

respective slot

56,58. The remaining portions (i.e., second portions62) remain outside thetube42. Thesecond portion62 can be defined on the outer radial portions of thecompressible members40. Also, each of the sets ofteeth38 can remain outside thetube42 because theteeth38 are spaced away on either side of the respective compressible members40 (along the respective rotational axis R1, R2). Also, thehandle member16 can include openings63 (FIGS. 1 and 4) that partially expose the respectivesecond portions62 of the

wheels

34,35 so that the user can contact the

wheels

34,35.

As shown inFIG. 2, thewire member14 can be a continuous, flexible wire having aproximal end64 and adistal end66. Thewire member14 can be made from Nitinol, a polymer or other suitable material. Thedistal end66 can include a diamond-shapedloop68. Theloop68 can be resiliently compressible. Also, in some embodiments, thedistal end66 can include opposed pinchers, a hook, or other devices. Thewire member14 can be moveably received within thehandle passage30 and thetube passage53. Specifically, to load thewire member14, thewire member14 can be inserted into thehandle passage30 defined by thehandle end22 and advanced along the axis X toward thetube42. Since thetube passage53 is coaxial with thehandle passage30, thewire member14 can advance easily into thefirst end44 of thetube42 and advance between the

wheels

34,35 as shown inFIG. 4. Then, the

wheels

34,35 can be rotated to further advance thedistal end66 toward thesecond end46 of thetube42.

It will be appreciated that thedistal end66 of thewire member14 can be relatively easily and conveniently advanced toward thesecond end46 of thetube42. This is because thetube42 is monolithic (i.e., single body, uni-body, etc.), because theopening59 is blocked by thehandle member16, and because the

slots

56,58 are blocked by thefirst portions60 of the

wheels

34,35. As such, thewire member14 has little or no ability to advance out of thetube42 until thedistal end66 reaches thesecond end46 of thetube42. Accordingly, thesuture passer assembly10 can be prepared for use relatively quickly and conveniently.

Moreover, once thewire member14 is loaded within theassembly10, theloop68 can be selectively advanced out and retracted into thesecond end46 of thetube42. This can be accomplished by drivingly rotating the

wheels

34,35. As mentioned above, the user can apply force to only one

wheel

34,35 and because the

wheels

34,35 are meshingly engaged, both

wheels

34,35 can advance thewire member14 for added convenience.

FIGS. 6-10 illustrate exemplary uses of thesuture passer assembly10. In some embodiments, thesuture passer assembly10 can be used to repair a damaged rotator cuff; however, it will be appreciated that thesuture passer assembly10 can be used for repairing any anatomical feature. Also, theassembly10 can be used arthroscopically in some embodiments.

As shown inFIG. 6, thesuture12 can include ananchor71 that can be anchored (e.g., threaded) into a first anatomical feature74 (e.g., bone tissue). Thesuture12 can also include two

flexible ties

72a,72bthat extend from the anchor. Thus, one or more incisions (not shown) can be made in the patient's skin, and theanchor71 can be fixed to the firstanatomical feature74. The

ties

72a,72bcan be initially untied as shown inFIG. 6.

Next, an opening, such as a piercing or anincision78 can be made in a second anatomical feature76 (e.g., soft tissue such as a torn rotator cuff). Theincision78 can be in communication with one or more other incisions formed within the patient's skin. Theincision78 can be made directly by the sharpened edges of thesecond end46 of thetube42. Alternatively, theincision78 can be made using another cutting tool. Also, a cannula (not shown) can be inserted into theincision78 and thesecond end46 of thetube42 can be advanced through theincision78 via the cannula.

Once thesecond end46 has been inserted through the incision78 (FIGS. 6 and 7), the

wheels

34,35 can be rotated in a first direction to advance theloop68 out of the second end46 (FIG. 7). Theloop68 can bias open to a width that is larger than that of thesecond end46.

Then, as shown inFIG. 8, atool73 can be inserted into the patient (e.g., through an incision that is not shown), and thetool73 can be used to grab one of theties72aand advance thetie72ainto theloop68 as indicated by the arrow inFIG. 8.

Once thetie72ahas been received in theloop68, the

wheels

34,35 of thesuture passer assembly10 can be rotated in a second direction to retract theloop68 back into thesecond end46. Specifically, as theloop68 retracts, theloop68 can resiliently flex to close around thetie72a. Thus, thetie72acan be restrained and captured within theloop68 and/or restrained between theloop68 and theinner tube surface50 of thetube42 as shown inFIG. 9.

Once thetie72ais restrained, the surgeon can pull theassembly10 back through theincision78, thereby pulling the tie72 through the incision. Subsequently, the

ties

72a,72bcan be tied in one or more conventional knots to thereby attach the first and second

anatomical features

74,76 together.

Accordingly, thesuture passer assembly10 can allow the user to conveniently load thewire member14 therein. Also, thesuture passer assembly10 can allow the user to comfortably and accurately control advancement of thewire member14 within thetube42. As a result, the user can more quickly and efficiently perform surgicalprocedures using sutures12.

The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.

Claims

What is claimed is:

1. A suture passer assembly for manipulating a suture with a selectively moveable wire member, the suture passer assembly comprising:

at least one grasping member; and

a single-body hollow tube having a tube wall extending from a first end to a second end and defining a tube passage extending from the first end to the second end, the wire member moveably received within the tube passage, the tube wall including at least one aperture extending through the tube wall to the tube passage that is disposed between the first end and the second end, a first portion of the at least one grasping member extending through the tube wall and into the tube passage via the at least one aperture, a second portion of the at least one grasping member remaining outside the hollow tube, the first portion operable to grasp the wire member and selectively move the wire member relative to the hollow tube due to manipulation of the second portion of the at least one grasping member.

2. The suture passer assembly ofclaim 1, further comprising a handle member, the handle moveably supporting the at least one grasping member and operably supporting the hollow tube.

3. The suture passer assembly ofclaim 1, wherein the handle member encloses the first end of the hollow tube and wherein the second end of the hollow tube is exposed from the handle member.

4. The suture passer assembly ofclaim 1, wherein the at least one grasping member comprises a first grasping member and a second grasping member, wherein the at least one aperture comprises a first aperture and an opposed second aperture extending through the tube wall to the tube passage, wherein the first grasping member is received within the first aperture and the second grasping member is received within the opposed second aperture, the first and second grasping members being operable to cooperatively and selectively move the wire member relative to the hollow tube.

5. The suture passer assembly ofclaim 4, wherein the hollow tube defines a longitudinal axis, and wherein the first aperture and the second aperture are substantially symmetrical with respect to each other on opposites sides of the longitudinal axis.

6. The suture passer assembly ofclaim 1, wherein the at least one grasping member includes a wheel that is rotationally supported relative to the hollow tube.

7. The suture passer assembly ofclaim 6, wherein the wheel includes a compressible member, the compressible member being received within the at least one aperture.

8. The suture passer assembly ofclaim 1, wherein the at least one grasping member includes a first wheel and a second wheel that cooperate to selectively move the wire member relative to the hollow tube, the first wheel including a first set of radial projections, the second wheel including a second set of radial projections, the first and second sets of radial projections being configured to cooperatively engage one another such that rotation of one of the first and second wheels drives the other of the first and second wheels.

9. The suture passer assembly ofclaim 8, wherein the first wheel is operable to rotate about a first rotational axis and the second wheel is operable to rotate about a second rotational axis, the first portion of the first wheel being spaced away from the first set of radial projections along the first rotational axis, the first portion of the second wheel being spaced away from the second set of radial projections along the second rotational axis, the first and second set of radial projections being disposed outside the hollow tube.

10. The suture passer assembly ofclaim 1, wherein the hollow tube defines a longitudinal axis, and wherein the at least one aperture is a slot that extends longitudinally substantially parallel to the longitudinal axis.

11. The suture passer assembly ofclaim 10, wherein the tube wall includes an outer tube surface and an inner tube surface, wherein the slot tapers outward from the inner tube surface to the outer tube surface.

12. The suture passer assembly ofclaim 1, further comprising the wire member.

13. A suture passer assembly for manipulating a suture with a selectively moveable wire member, the suture passer assembly comprising:

at least one grasping member; and

a single-body hollow tube having a tube wall extending from a first end to a second end and defining a tube passage extending from the first end to the second end, the wire member moveably received within the tube passage, the tube wall including at least one aperture extending through the tube wall to the tube passage that is disposed between the first end and the second end, a first portion of the at least one grasping member extending through the tube wall and into the tube passage via the at least one aperture, a second portion of the at least one grasping member remaining outside the hollow tube, the first portion operable to grasp the wire member and selectively move the wire member relative to the hollow tube due to manipulation of the second portion of the at least one grasping member, wherein the hollow tube is curved at the second end, and wherein the second end includes a sharpened edge.

14. A suture passer assembly for manipulating a suture, the suture passer assembly comprising:

a wire member;

a grasping member having a first wheel and a second wheel that are each rotatable; and

a single-body hollow tube having a tube wall that extends substantially along a longitudinal axis from a first end to a second end and defining a tube passage extending from the first end to the second end, the wire member moveably received within the tube passage, the tube wall including a first slot and a second slot that are each disposed between the first end and the second end and that are disposed on opposite sides of the longitudinal axis, each slot extending through the tube wall to the tube passage, the first wheel partially extending through the first slot and into the hollow tube, the second wheel partially extending through the second slot and into the hollow tube, the first and second wheels operable to cooperatively grasp the wire member within the tube passage such that driving rotation of at least one of the first wheel and the second wheel advances the wire member relative to the tube.

15. The suture passer assembly ofclaim 14, wherein the first wheel includes a first set of radial projections, wherein the second wheel includes a second set of radial projections, and the first and second sets of radial projections are meshingly engaged such that rotation of one of the first and second wheels rotatably drives the other of the first and second wheels.

16. The suture passer assembly ofclaim 14, wherein both the first and second wheels includes a compressible member that resiliently compresses radially when grasping the wire member.

17. The suture passer assembly ofclaim 14, wherein the first slot and first wheel are disposed substantially symmetrically about the longitudinal axis relative to the second slot and the second wheel.

18. The suture passer assembly ofclaim 14, wherein the tube wall includes an outer tube surface and an inner tube surface, wherein the first slot tapers outward from the inner tube surface to the outer tube surface, and wherein the second slot tapers outward from the inner tube surface to the outer tube surface.

19. The suture passer assembly ofclaim 14, further comprising a handle member, the handle member movably supporting the first wheel and the second wheel relative to the hollow tube.

20. The suture passer assembly ofclaim 19, wherein the handle member encloses the first end of the hollow tube and wherein the second end of the hollow tube is exposed from the handle member.

21. The suture passer assembly ofclaim 14, wherein the hollow tube is curved at the second end, and wherein the second end includes a sharpened edge.

22. The suture passer assembly ofclaim 14, wherein the first wheel is operable to rotate about a first rotational axis and the second wheel is operable to rotate about a second rotational axis, a portion of the first wheel partially extending through the first slot being spaced away from the first set of radial projections along the first rotational axis, a portion of the second wheel partially extending through the second slot being spaced away from the second set of radial projections along the second rotational axis, the first and second set of radial projections being disposed outside the hollow tube.